The ambient scribe for domiciliary care. We listen so carers don't have to type.
CareSignal is an ambient AI care scribe for UK domiciliary (home) care. A carer activates the app at the start of a home visit, and CareSignal listens, transcribes, and structures the conversation into a complete care note with 10 structured fields mapped to CQC's five inspection domains, ready for review and submission in under 60 seconds.
Built for HSIL Harvard Health Systems Hackathon 2026 (Challenge #6: Shortage of Healthcare Workers) at UCL Hub, London.
| Pillar | Description | Status |
|---|---|---|
| Ambient AI Scribe | On-device audio capture + Gemini 2.5 Flash extracts 10 structured care fields from natural conversation in 9 languages | Built |
| Pre-Visit AI Brief | Auto-generated brief from visit history with flags, care plan changes, patient preferences, and ElevenLabs voice narration | Built |
| Lone Worker Safety | One-tap emergency: GPS + Google Maps location link to agency contact with Twilio SMS backup | Built |
| Manager Dashboard | Visit feed, calendar view, analytics, anomaly flags, CQC-ready PDF report export, quick messaging | Built |
| Notifications & Comms | Pre-visit reminder emails (Resend), district nurse insights summaries, in-app chat persisted to Firestore | Built |
| Care System Integrations | Export to Birdie, PASS (everyLIFE), generic NHS Digital format, and FHIR R4 Bundle with SNOMED CT coding | Built |
Each field maps to CQC's five inspection domains (Safe, Effective, Caring, Responsive, Well-Led):
| Field | CQC Domain | Example |
|---|---|---|
| Fluid Intake | Safe | 450ml |
| Food Intake | Effective | Half portion of soup |
| Mood | Caring | Cheerful, engaged |
| Mobility | Safe | Walked unaided |
| Personal Care | Effective | Wash completed |
| Medication | Safe | Morning tablets given |
| Pain Level | Caring | Mild, 3/10 |
| Wellbeing | Caring | Seemed lonely |
| Carer Concerns | Responsive | Bruising on arm |
| Visit Duration | Well-Led | 28 min |
- React 18 + TypeScript + Vite
- Tailwind CSS v4 with custom design tokens
- Framer Motion for animations
- Recharts for analytics charts
- jsPDF for CQC report export
- React Router v6
- Node.js + Express
- Google Cloud Speech-to-Text (9 languages, enhanced model)
- Google Gemini 2.5 Flash (structured field extraction, pre-visit briefs)
- ElevenLabs (text-to-speech, Sarah voice, turbo v2.5 model)
- Twilio (emergency SMS + pre-visit SMS reminders)
- Resend (transactional email with styled HTML templates)
- Firebase Admin SDK + Firestore
- GCP project:
caresignal-hsil(europe-west2 / London) - Firestore: native mode, europe-west2
- Privacy-by-design: audio deleted post-transcription, transcripts are transient, only structured fields persist
- TLS 1.3 in transit, AES-256 at rest
- Node.js 18+
- Google Cloud CLI (
gcloud) authenticated - GCP project with Speech-to-Text, Firestore, and Generative Language APIs enabled
# Clone
git clone https://github.com/faith-ogun/CareSignal.git
cd CareSignal
# Backend
cd backend
npm install
cp .env.example .env # Edit with your API keys
npm start # Runs on http://localhost:3001
# Frontend (new terminal)
cd frontend
npm install
npm run dev # Runs on http://localhost:5173# Google Cloud
GEMINI_API_KEY=your_gemini_api_key
GEMINI_MODEL=gemini-2.5-flash
GCP_PROJECT_ID=caresignal-hsil
# ElevenLabs (TTS)
ELEVENLABS_API_KEY=your_elevenlabs_key
# Twilio (SMS)
TWILIO_ACCOUNT_SID=your_twilio_sid
TWILIO_AUTH_TOKEN=your_twilio_token
TWILIO_PHONE_NUMBER=+1...
EMERGENCY_CONTACT=+44...
# Resend (Email)
RESEND_API_KEY=your_resend_key
CARER_EMAIL=carer@example.com
PORT=3001| Method | Endpoint | Description |
|---|---|---|
| GET | /api/health |
Service status check |
| GET | /api/languages |
List supported transcription languages |
| GET | /api/visits |
Get completed visits (Firestore) |
| POST | /api/visits |
Save completed visit (Firestore) |
| GET | /api/alerts |
Get emergency alerts (Firestore) |
| POST | /api/alerts |
Save emergency alert (Firestore) |
| POST | /api/transcribe |
Audio file upload to transcript (multilingual) |
| POST | /api/transcribe-base64 |
Base64 audio to transcript (multilingual) |
| POST | /api/extract |
Transcript to 10 structured care fields |
| POST | /api/emergency |
Lone worker emergency SMS alert |
| POST | /api/pre-visit-brief |
Generate pre-visit brief from history |
| POST | /api/tts |
Text to speech via ElevenLabs |
| POST | /api/send-reminder |
Pre-visit reminder (email + SMS) |
| POST | /api/send-summary |
District nurse insights summary email |
| GET | /api/messages |
Get chat messages (Firestore) |
| POST | /api/messages |
Save chat message (Firestore) |
CareSignal supports 9 languages for speech-to-text transcription, covering the most spoken languages in the UK care sector:
| Language | Code | Use Case |
|---|---|---|
| English (UK) | en-GB | Default |
| Polish | pl-PL | Largest non-English group in UK |
| Punjabi | pa-IN | Second most spoken South Asian language |
| Urdu | ur-PK | Widely spoken in care communities |
| Bengali | bn-BD | Significant diaspora population |
| Arabic | ar-SA | Growing care workforce |
| Chinese (Mandarin) | zh-CN | Service users with Mandarin preference |
| Cantonese | yue-Hant-HK | Hong Kong diaspora community |
| Yoruba | yo-NG | West African diaspora |
Language is automatically selected based on service user preference and can be set per visit.
CareSignal exports structured care data for import into existing UK care management platforms:
| Platform | Format | Use Case |
|---|---|---|
| Birdie | JSON / CSV | Direct import into Birdie care management |
| PASS (everyLIFE) | JSON / CSV | Care plan and observation sync |
| Generic NHS | JSON / CSV | Interoperable format for other providers |
| FHIR R4 Bundle | JSON | NHS Spine, GP Connect, Shared Care Records with SNOMED CT coding and UKCore profiles |
The FHIR R4 export produces a valid Bundle containing Patient, Practitioner, Encounter, Observation, and ClinicalImpression resources with:
- UKCore structure definition profiles
- SNOMED CT concept codes for care observations
- Confidence scores as FHIR extensions
- CQC domain tagging per observation
- 595,000 home care workers in England
- 59,000 unfilled posts (13% vacancy rate, 4x national average)
- 30 to 48 minutes per shift lost to documentation
- 297,500 hours of care capacity lost to paperwork every day
- 24.7% annual staff turnover
Sources: Skills for Care 2025, HSE 2024/25
CareSignal turns documentation from a manual task into an ambient process. Three taps, under 60 seconds: Start Visit, End Visit, Submit Note.
At scale (10% UK market penetration), CareSignal returns the equivalent of 90,000 FTE carers' time back to direct care.
Grounded in 30+ peer-reviewed papers from PubMed, medRxiv, WHO, and The Lancet across eight research pillars: ambient AI scribes, patient presence, home care admin burden, lone worker safety, NLP/LLM extraction, workforce crisis, AI ethics, and health systems frameworks.
- Audio is ephemeral: deleted immediately after transcription
- Transcripts are transient: used only for field extraction, then deleted
- Only structured, carer-approved fields are persisted
- TLS 1.3 in transit, AES-256 at rest
- GDPR-compliant data minimisation by design
- UK data residency (GCP europe-west2)
Built at UCL Hub, London for the HSIL Harvard Health Systems Hackathon 2026.
MIT